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PRINTED: DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES STATEMENT OF DEFICIENCIES(X1) PROVIDER/SUPPLIER/LIGAND PLAN OF CORRECTIONIDENTIFICATION NUMBER:15564911/24/2015FORM
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Survey date 110515 refers to May 15, 2011.
All individuals or entities specified in the survey instructions are required to file.
The survey must be filled out according to the instructions provided by the surveying authority.
The purpose of survey date 110515 is to collect specific information as required by the surveying authority.
The information required to be reported on survey date 110515 will be specified in the survey instructions.
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